MDS Subject Matter Expert-Remote

MDS Subject Matter Expert Job Description

Position Summary

Job Title

MDS Subject Matter Expert (SME)

Job Overview

Rainmakers Strategic Solutions, a fast-growing woman-owned small business, provides management consulting services for federal government clients. Many of Rainmakers’ contracts support federal health care programs such as Medicare and Medicaid. A significant number of our contracts involve updating publicly available documents for digital and print publication in response to changes in policies and healthcare benefits. We pride ourselves in upholding high standards for delivering quality products and services under aggressive timelines.

The Subject Matter Expert (SME) for Minimum Data Set (MDS) and Resident Assessment Instrument (RAI) serves as a high-level strategic advisor and technical authority. This role provides critical support to the Centers for Medicare & Medicaid Services (CMS) and the RSS team under the MDS/RAI User’s Manual Support and Maintenance contract. The SME ensures clinical accuracy, regulatory compliance, and educational efficacy of the primary assessment tools used by over 15,000 nursing homes nationwide. The SME is the primary clinical authority for the MDS/RAI Q&A database and the architect of national training programs. This role ensures that every response provided to a State Agency and every slide presented at a national conference is clinically accurate, regulatory-compliant, and aligned with the RAI User’s Manual .

Key Responsibilities

• Resolve complex coding and assessment inquiries from State RAI Coordinators and providers ensuring all guidance is defensible, clinically sound, and consistently applied across all CMS helpdesk channels.
• Manage and provide expert responses to questions submitted through official help desks and training sessions, utilizing the approved Q&A database.
• Maintain and utilize the MDS Q&A database to ensure response consistency.
• Analyze inquiry trends to identify interpretive inconsistencies and documentation ambiguity where manual revisions are required to ensure stakeholder alignment.
• Serve as the final review authority for all draft responses concerning MDS 3.0 and RAI processes, ensuring clinical integrity and operational clarity prior to stakeholder distribution.
• Co-lead the 90-day pre-event submission cycle for all training packets, ensuring curricula, instructor guides, and risk assessments are delivered for COR and CMS Training Department reviews on schedule.
• Support the design, development, and quality review of training materials for MDS 3.0 providers and State RAI Coordinators.
• Lead and participate in investigative projects regarding proposed changes to the MDS item set or manual revisions to ensure functional alignment with legislative requirements.
• Ensure all resident assessment and comprehensive care planning activities align with the Medicare Prospective Payment System (PPS), SNF Quality Reporting Program (QRP), and LTC regulations.
• Participate in weekly client and internal team meetings to ensure cross-functional alignment and provide operational updates on key project deliverables.

• Ad hoc assignments as appropriate.

Statement of Other Duties

This document describes the essential functions, requirements, and responsibilities of this job, and is not intended to be a complete list of all tasks and functions. Employees may be requested to perform job-related tasks other than those specifically listed in this description and may be required to perform any task requested by the supervisor or management.

Knowledge, Skills, and Experience

Education
(degree, area(s) of study)

• Masters are preferred.

Years of Experience

• A minimum of 10+ years of clinical, educational, and regulatory experience, with over fifteen years of direct support for the MDS/RAI project.

Relevant Past Experience

• Demonstrates a thorough understanding of the RAI process—including Care Area Assessment (CAA) completion—the Medicare Prospective Payment System (PPS), and direct experience with MDS or other post-acute care (PAC) assessment instruments.
• Experienced in document management and SharePoint maintenance.
• Knowledge of medical terminology is strongly desired.
• Experience working with health care documents preferred.

Special Skills

• Strong organizational skills.
• Sound written and oral communication skills.
• Demonstrated ability to work effectively remotely within a team environment.
• Experience working in a client service role.

Software Proficiency

• Proficiency in word processing and spreadsheets.
• Full proficiency in Microsoft Products (Word, Excel, PowerPoint, Outlook, etc.) Google Applications (Docs, Sheets), and Adobe PDF.